the doctors’ worries.

the hospital uses a variation of the wong-baker faces scale to measure pain, from one (happy) to ten (hurts real bad). the scale, as can be seen in the link, offers drawings of faces to make quantifying pain easier. honestly, though, having the pictorial representations (and words, for that matter), makes it more difficult. i have problems with everything from the idea that someone can’t be happy but still in pain to the use of the adjective real rather than the adverb really to tears only being present with the highest amount of pain (perhaps i’m a wimp, but i cry often when my pain reaches a three), but i guess this isn’t the point.

until recently, my mom could measure her pain on one hand after being given an additional dose of medication, but increasingly infrequent are the times when it dips below a seven now. seven has become the goal, the nadir, manageable.

i’ve been thinking a lot about pain tolerances. for instance, how would she rate the worst pain i’ve endured in my life? during baseball practice, from the pitcher’s mound, i tried to catch a line drive with my bare hand and dislocated my right ring finger, but i’m inclined to score this pretty low on the scale, even if my face resembled the guy in the final stage, since i went back onto the field to play first base after my dad popped it back in place. other injuries occured too early in my youth to trust any memories associated with them.

also, if seven is her baseline, how long could i continue with even a five or, god forbid, six before submitting? to get an idea of her threshold and how they might compare with mine, i researched her medication, specifically a fentanyl pain patch which remains effective for seventy-two hours, and its recreational use, of which, thankfully, many interpid souls have experimented and documented on the internet.

first, let me explain that it’s eighty times more potent than morphine. in some places it’s sold as heroin, leading to overdoses, as it’s hundreds of times more potent and produces significantly worse respiratory depression. those that had used it reported hours of drooling, shortness of breath, and other unpleasantries, namely, replacing heroin’s euphoria with sedation, and cautioned others from following their lead, detailing how easy it was to overdose.

as i read more, in some shock (a four on the shock scale, perhaps) at what my mom is enduring, i realized something that quickly increased the shock to nine (the only reason it wasn’t higher is because i’m not one of those people who believes that one can exceed the boundaries of a scale (that is, i cannot possibly give 110%) and because i am one of those people who is too fearful to speak in extremes): none of the accounts mentioned more than a fifty microgram patch.

certainly much can be said about my mother’s opiod dependence by this time in her treatment, but i think it says more about her tenacity and spirit (and her inhuman ability to withstand pain) that she continues to communicate (and joke) with us even though one hundred and fifty micrograms of fentanyl are being released hourly from her body fats into her blood stream.